Rhode Island home and auto insurance from Capital Insurance Group Rhode Island insurance from Capital Insurance Group
Your Rhode Island Insurance Savings is "Just One Click Away!"
Personal Auto, Homeowners Insurance from Capital Insurance Group
Personal Auto Insurance

Homeowners Insurance

Renters Insurance

Motorcycle Insurance

Boat Insurance

Progressive 24/7 Quotes or Service
Business, workers comp, and Contractor Insurance Products from Capital Insurance Group

Businessowners Insurance

General Liability Insurance

Commercial Auto Insurance

Commercial Property Insurance

Contractors Programs

Workers Comp Insurance


Life and Health Insurance Products from Capital Insurance Group

Life Insurance

Disability Insurance


Other Insurance Services from Capital Insurance Group
Service My Account

More About Our Agency

Map/Office Directions

Questions? E-Mail Us!

Capital Insurance Group Guarantees your satisfaction
 
On-Line Commercial
Vehicle Quote Form
One Simple Form - takes only 2-3 Minutes!


YOUR PERSONAL DATA:

Your Name:
Business Name:
Street Address:
City:
State: (Must be Rhode Island)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail (Again, for Accuracy):
Phone:
Fax (optional):
 
Currently Insured?
(If yes, list carrier, and # of years
continuous. If no, type NONE)
 
Type of Business:
(Please be specific, and
tell how vehicles are used.)


 
DRIVER INFORMATION #1
(if more than two drivers,
list in remarks)
Name: Birthdate:
Sex: # Years U.S.
 Auto License:
Number & Type of
Accidents within
last 3 years:
Number & Type of
MINOR violations within
last 3 years:
Number & Type of
MAJOR violations within
last 3 years:
Daily commute
in ONE WAY miles:
Does Driver need
an SR22 FILING?
Yes No Comments or
Remarks?
 
DRIVER INFORMATION #2 (if none, leave blank)
Name: Birthdate:
Sex: # Years U.S.
 Auto License:
Number & Type of
Accidents within
last 3 years:
Number & Type of
MINOR violations within
last 3 years:
Number & Type of
MAJOR violations within
last 3 years:
Daily commute
in ONE WAY miles:
Does Driver need
an SR22 FILING?
Yes No Comments or
Remarks?


COMMERCIAL VEHICLE #1:
If more than 2 vehicles, list in remarks
or call us at: 401-349-5757
Year of vehicle: Make & Model:
Type (truck, tow-truck, bobtail, etc.): Length in Feet:
Gross Vehicle Weight: Cost
New: $
Radius of operation: Value $:
List Special Equipment & Values
(i.e., rack, tool box, etc.)

VEHICLE ID#
(highly suggested for accurate rating)

VEHICLE #1 COVERAGES:
Limits of
Liability:
$500,000 CSL
$750,000 CSL
$1 Million CSL
 
Comprehensive
& Collision:
NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Do you want
Medical Coverage?
Yes No   Uninsured
  Motorists?
Yes No
 
COMMERCIAL VEHICLE #2:
Year of vehicle: Make & Model:
Type (truck, tow-truck, bobtail, etc.): Length in Feet:
Gross Vehicle Weight: Cost
New: $
Radius of operation: Value $:
List Special Equipment & Values
(i.e., rack, tool box, etc.)

VEHICLE ID#
(highly suggested for accurate rating)



VEHICLE INFORMATION FOR UNITS #3-5:
(If none, Leave Blank)
VEHICLE #3
(List Year, Make, Model & Value)
VEHICLE #4
(List Year, Make, Model & Value)
VEHICLE #5
(List Year, Make, Model & Value)


VEHICLE #2 - #5 COVERAGES:
Limits of
Liability:
$500,000 CSL
$750,000 CSL
$1 Million CSL
 
Comprehensive
& Collision:
NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Do you want
Medical Coverage?
Yes No   Uninsured
  Motorists?
Yes No
 
Send my quotation via: E-Mail Fax
Regular Mail
Call Me by Phone

 
Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a
Commercial Vehicle Quote NOW!


Help Us Fight Spam! Type the Numerical Code you see at right, into the empty text box on the left, so we know you are a human. Thanks for your help!

Enter code at right, here:
Web Form Protection Code
reload image

Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!

Capital Insurance Group, LLC . 454 George Waterman Road . Johnston, RI 02919
Phone: 401-349-5757 | Fax: 401-349-5756 | E-Mail us at: info@riautoinsurancequote.com
Our Telephone Quoting Hours are: 9:00am to 5:00pm (Monday-Friday)
View Our Privacy Notice | Website Design © 2016, Insurance Web Sales